Manuscript Accepted

The following manuscript was accepted for publication in the Archives of Physical Medicine and Rehabilitation and utilized research from NIH 10yr, NIDRR 10yr, RRTC, and DRRP:

Saunders, L.L., Krause, J.S., & Acuna, J. (in press). Association of race, socioeconomic status, and health care access with pressure ulcers after spinal cord injury. Archives of Physical Medicine and Rehabilitation.

ABSTRACT
Objective: To assess the associations of race and socioeconomic status (SES) with pressure ulcers (PU) after accounting for health care access (HCA) among persons with spinal cord injury (SCI).

Design: Cross-sectional.

Setting: Large specialty hospital in the southeastern United States.

Participants: Persons with traumatic SCI who 1) had residual effects from their injury, 2) were 18 years or older at survey, and 3) were a year or more post-injury at survey (n=2,549).

Intervention: None.

Main Outcome Measures: Outcomes were measured by mail-in survey: having a current PU (yes vs. no), having a PU in the past year with or without reduced sitting time (no PU, no reduced sitting time, month or less, 5+ weeks), and having at least 1 PU surgery since SCI onset (yes vs. no).

Results: Of participants, 39.3% reported a PU in the past year, 19.9% had a current PU, and 21.9% reported having had surgery for a PU since their SCI onset. While race was preliminarily associated with each PU outcome, it became non-significant after controlling for SES and HCA. In each analysis, household income was significantly associated with PU outcomes after controlling for demographic and injury factors and remained significant after accounting for the HCA factors. Persons with lower income had higher odds of each PU outcome. HCA was not consistently related to PU outcomes.

Conclusions: Even after accounting for HCA, household income, a measure of SES, remained significantly associated with PU outcomes after SCI; however, race became non-significant.

Key Words: spinal cord injury; pressure ulcer; race; socioeconomic factors; health services accessibility

RRTC and DRRP In-service

RRTC & DRRP In-service at the Disability Resource Center (ILC)

On February 6, 2012, our consumer advocate, Richard Aust, from MUSC conducted an in-service meeting for the RRTC & DRRP at the Disability Resource Center (DRC ILC) in North Charleston, South Carolina. Mr. Aust met with all DRC staff to discuss the ongoing SCI research activities of the RRTC & DRRP. DRC staff were every receptive to getting involved to disseminate RRTC & DRRP study results as they become available. Given that 19 % of the SCI surveillance participants reported receiving no in-patient or out-patient rehabilitation services, DRC executive director, Gwen Gillenwater, expressed that she would be interested in coordinating secondary conditions trainings for SCI consumers in the Tri-county area (Charleston, Dorchester, Berkley) in the areas of preventing skin sores, UTI and other trainings as recommended by Shepherd Center staff. Note that Shepherd Center is currently conducting in-service trainings to rehabilitation staff through South Carolina in order to reinforce the most effective practices to reduce secondary conditions after SCI.

In addition, DRC staff are very involved in working with the Latino population in Charleston, Berkley and Dorchester counties. Liuana Zanouski, DRC Latino Outreach Coordinator, agreed to meet with our staff member, Josh Acuna, to establish a working relationship in order to disseminate SCI underserved population study results. DRC staff, Rachel McCammon, expressed that she worked with an American Indian outreach organization, the Grandmothers’ Council, in Pennsylvania. She agreed to forward Mr. Aust contact information for future dissemination of DRRP study results.

Mr. Aust discussed the need of DRC to update their website to create a research link under their education track. Ms. Gillenwater agreed to create the research link to provide research information on a variety of disability topics. Nathan Todd, DRC Program Coordinator, is in the process of redesigning the DRC website and confirmed that he will create a research link.

Grand Rounds link

Please click the link below to view our Grand Rounds from January 24. Dr. Sara Kraft, PT, DPT, NCS, ATP of MUSC's Division of Physical Therapy spoke on “The Seating Interface for the Individual with SCI: Minimizing Risk and Maximizing Function."


http://chpondemand.musc.edu/rehab_int/Grand_Rounds_01_24_12.mp4

January Grand Rounds

On Tuesday, January 24, 2012, we hosted our quarterly SCI Grand Rounds for the RRTC grant. Dr. Sara Kraft, PT, DPT, NCS, ATP of MUSC's Division of Physical Therapy spoke on “The Seating Interface for the Individual with SCI: Minimizing Risk and Maximizing Function." The four learning objectives were:

1. Identify three reasons to use a wheelchair cushion
2. Identify when a client is at high risk for pressure ulcers
3. Understand the mechanisms of pressure ulcers from the seated position
4. Select which type of cushion interface would be most appropriate for specific clients

In the presentation, Dr. Kraft discussed intrinsic and extrinsic factors related to pressure ulcers, as well as the most common sites for the ulcers. She described the types of patients that are low, moderate, and high risk for pressure ulcers and then presented guidelines to prevent pressure and friction in a wheel chair, in order to prevent pressure ulcers. Dr. Kraft had sample wheelchair support devices and cushions for the audience to visualize and test out and she demonstrated the proper cushioning techniques.

The presentation was very well received by the audience. Sixty four attendees came to the Grand Rounds which included physicians, nurses, PT's, OT's, and PhD research faculty from MUSC, VA Hospital, and Roper Hospital. All attendees were eligible to receive one credit hour of CME credit or CEU nursing credit. Our next Grand Rounds will be in April 2012 at MUSC.

SCI Research Team Retreat

Dr. James Krause at MUSC held an SCI team retreat last week to discuss current research studies, updates, and plans for the future. The entire team met for two days and went over data collection, data findings, training opportunities, educational opportunities, publications, presentations, and consumer dissemination. Visitors from SCSCIA attended the retreat to give valuable insight and information. The team was able to construct many plans and guidelines for successful future research and dissemination. We are looking forward to a successful 2012!

Courage Award News

As previously reported, Dr. James Krause was awarded the Courage Award in September 2011. The Medical University of South Carolina newsletter, The Catalyst, posted an exceptional article about this news which can be viewed at the following link:

http://www.musc.edu/catalyst/archive/2011/co11-25courage.html

In addition, MUSC also conducted an interview with Dr. Krause talking about this award. You can view this interview at the following link:

http://etl2.library.musc.edu/krause/

Fall Newsletters

Please view the links below to check out our Fall Newsletters!

SCIORG:

http://academicdepartments.musc.edu/chp-new/sciorg/pdfs/Newsletters/SCIORG%20NEWSLETTER_FALL%202011_10-20-11_.pdf

CHORCUP:

http://academicdepartments.musc.edu/chp-new/CHORCUP/PDFs/Newsletters/CHORCUP%20NEWSLETTER%20FALL%202011_10-19-11.pdf


RRTC:

http://academicdepartments.musc.edu/chp/rrtc/PDFs/RRTC%20NEWSLETTER_FALL%202011_10-19-11.pdf